Mild cognitive impairment (MCI) describes memory or thinking changes that are noticeable but don't interfere much with daily life. About 15-20% of people over 65 have MCI. Some cases progress to dementia, some stay stable for years, and some improve. There's no FDA-approved treatment yet, though lifestyle interventions and managing vascular risk factors are recommended.
What's actually going on in research
Trials are testing anti-amyloid antibodies that cleared plaques in early Alzheimer's to see if they work earlier in MCI, tau-targeting drugs that address a different brain protein, drugs aimed at inflammation and metabolism in the brain, and cognitive training programs. Researchers are also studying biomarkers to predict who will progress and who won't.
Anti-amyloid antibodies
Drugs like lecanemab and donanemab, approved for early Alzheimer's, are being tested in people with MCI to see if starting treatment earlier slows progression. These drugs clear amyloid plaques from the brain.
Vascular protection
Studies are testing whether controlling blood pressure, diabetes, and cholesterol more aggressively can slow cognitive decline. Some trials combine multiple vascular interventions at once.
Lifestyle interventions
Trials are testing structured programs combining exercise, diet, cognitive training, and social activity. The FINGER study in Finland showed such programs can help, and similar trials are running elsewhere.
What to know before you search
Eligibility typically depends on memory test scores, whether amyloid is present in the brain, age, and absence of other causes of cognitive problems.
What types of trials are currently open
- Drug trials — Testing medications that target amyloid, tau, inflammation, or brain metabolism to see if they prevent progression to dementia.
- Prevention trials — Testing interventions in people with MCI or even earlier to delay or prevent Alzheimer's disease.
- Lifestyle trials — Studies of exercise, diet, cognitive training, or combinations to see if they slow cognitive decline.
- Biomarker studies — Research using brain scans, spinal fluid, or blood tests to identify who will progress and who will stay stable.
- Cognitive training — Testing computer-based or therapist-led programs designed to improve memory and thinking skills.
Recently added Mild Cognitive Impairment trials
Prevalence of Mild Cognitive Impairment and Dementia in Patients Admitted to Non-neurological Rehabilitation Wards
Cognitive impairment is common among older adults hospitalized for non-neurological conditions but often goes unrecognized, particularly in rehabilitation settings where clinical attention is mainly focused on physical recovery. The COGinREHAB study is a multicenter, prospective, longitudinal interventional study conducted at three rehabilitation centers of the Fondazione Don Carlo Gnocchi in Italy (Florence and Milan). The study will enroll 384 patients aged 45 years or older who are hospitalized for at least 7-10 days in cardiac, pulmonary, or orthopedic intensive rehabilitation units, or in intermediate care units, for conditions unrelated to the nervous system. At admission, all participants undergo a clinical and cognitive screening visit. Patients whose screening results suggest possible cognitive impairment then undergo a more extensive neuropsychological evaluation. In those with confirmed cognitive impairment, additional blood tests are performed to measure biomarkers of neurodegeneration (GFAP, neurofilament light chain, and phosphorylated tau-217), together with APOE genotyping and a non-contrast brain CT scan. In a subset of these patients, resting-state EEG, auditory event-related potentials, actigraphy, and overnight polysomnography are also performed. Patients with confirmed cognitive impairment are invited to a follow-up visit 12 months later to assess whether their cognitive profiles and biological markers have changed. The main purpose of the study is to estimate how frequently cognitive impairment occurs among patients admitted to non-neurological rehabilitation units, including how often it was previously undiagnosed. The study will also describe the clinical, biological, and neurophysiological profile of these patients and examine how cognitive impairment evolves over one year.
Digital Solutions for Predicting the Biological Mechanisms of Alzheimer's Disease Through the Analysis of Risk Factors
Population ageing is one of the main factors responsible for the global increase in the prevalence of dementia. Recent evidence suggests that modifiable risk factors, such as cardiovascular disease and lifestyle, may increase the risk of developing dementia and contribute to its progression. Furthermore, the use of non-invasive plasma biomarkers enables the identification of individuals with neurodegenerative diseases, even in the prodromal stage. However, the relationship between the cumulative burden of risk factors and plasma biomarkers is still poorly understood. The main objective of this study is to identify and estimate the risk associated with modifiable and non-modifiable predictors (risk factors) linked to the development of Alzheimer's disease (AD) and non-AD dementia, as well as biological alterations consistent with AD or non-AD, through the development of a predictive tool based on Artificial Intelligence algorithms (Machine Learning model). The study also aims to provide a range of technological tools (an app for active patient monitoring and a web platform for clinicians) that could improve risk stratification and the personalisation of care pathways. The study is divided into two different phases. Firstly, a retrospective phase is conducted in order to construct a predictive model for the risk of dementia and biological alterations consistent with AD. Secondly, a prospective phase is performed for the validation of the predictive model.
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